Abstract
Objective To report features of retinal fluorescein (FA) and indocyanine green (ICGA) angiography and optical coherence tomography (OCT) at successive stages of Vogt-Koyanagi-Harada (VKH) disease.
Methods FA and ICGA were systematically performed in cases of VKH disease, at admission, 1 month later, and at the end of the follow-up. In addition, the most recent patients underwent OCT. In the follow-up, the clinical evolution and extent of treatment were related to the angiographic and tomographic features.
Results FA and ICGA showed a diffuse delayed choroidal perfusion, including a delayed arterial, choriocapillar, and venous filling. This delayed choroidal perfusion involved the posterior pole and the hole periphery. The classically described serous retinal detachments were slowly filled from numerous pin points that could correspond to leakage through areas of damaged retinal pigment epithelium due to the choroidal ischemia. An uneven background choroidal fluorescence visible at the mid phase of ICGA was the result of multiple hypofluorescent round lesions in the choroidal stroma. Choroidal folds appeared hypofluorescent in FA and hyperfluorescent in ICGA. Some of these angiographic findings were present at the very early neurologic stage of the disease. Moreover, under treatment, a persisting altered choroidal perfusion could increase the incidence of retinal detachment relapses.
Discussion Various pathological conditions are characterized by choroidal involvement and serous retinal detachment. Angiographical findings may be helpful in the diagnosis.
Conclusion FA coupled with ICGA can be an useful tool in the early diagnosis of VKH disease as well as during the tapering of immunosuppressive drugs.
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References
Read RW, Holland G, Rao NA, Tabbara KF, Ohno S, Arellanes-Garcia L, Pivetti-Pezzi Paola, Tessler HH, Usui M (2001) Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 131:647–652
Babel J (1932) Syndrome de Vogt Koyanagi. Schweiz Med Wochenschr 44:1136–1140
Herbort CP, LeHoang P, Guex-Crozier Y (1998) Schematic interpretation of indocyanine green angiography in posterior uveitis using a standard angiographic protocol. Ophthalmology 105:432–440
Kohno T, Miki T, Shiraki K, Kano K, Matsushita M, Hayashi K, De Laey JJ (1999) Substraction ICG angiography in Harada’s disease. Br J Ophthalmol 83:822–833
Fardeau C, Herbort CP, Kullmann Nathalie, Quentel G, LeHoang P (1999) Indocyanine green angiography in Birdshot chorioretinopathy. Ophthalmology 106:1928–1934
Chang AA, Morse LS, Handa JT, Morales RB, Tucker R, Hjelmeland L, Yannuzzi LA (1998) Histologic localization of indocyanine green dye in aging primate and human ocular tissues with clinical angiographic correlation. Ophthalmology 105:1060–1068
Young NJA, Bird AC, Sehmi K (1980) Pigment epithelial diseases with abnormal choroidal perfusion. Am J Ophthalmol 90:607–618
Shimizu K (1973) Harada’s, Behcet’s, Vogt-Koyanagi syndromes – are they clinical entities? Trans Am Acad Ophthalmol Otolaryngol 77:281–290
Gaudric A, Coscas G, Bird AC (1982) Choroidal ischemia. Am J Ophthalmol 94:489–498
Stern WH, Ernest JT (1974) Microsphere occlusion of the choriocapillaris in rhesus monkeys. Am J Ophthalmol 78:438
Gaudric A, Sterkers M, Coscas G (1987) Retinal detachment after choroidal ischemia. Am J Ophthalmol 104:364–372
Amalric P (1963) Le territoire choriorétinien de l’artère ciliaire longue postérieure. Etude clinique. Bull Soc Ophthalmol 63:342
Bouchenaki N, Herbort CP (2001) The contribution of indocyanine green angiography to the appraisal and management of Vogt-Koyanagi-Harada disease. Ophthalmology 108:54–64
Oshima Y, Harino S, Hara Y, Tano Y (1996) Indocyanine green angiographic findings in Vogt-Koyanagi-Harada disease. Am J Ophthalmol 122:58–66
Green WR (1986) Vogt-Koyanagi-Harada syndrome. In: Spencer WH (ed) Ophthalmic pathology. An atlas of textbook. Saunders, Philadelphia
Read RW, Rechodouni A, Butani N, Johnston R, Labree LD, Smith RE, Rao NA (2001) Complications and prognostic factors in Vogt-Koyanagi-Harada disease. Am J Ophthalmol 131:599–606
Rubsamen PE, Gass JD (1991) Vogt-Koyanagi-Harada syndrome. Clinical course, therapy, and long-term visual outcome. Arch Ophthalmol 109:682–687
Maruyama Y, Kishi S (2004) Tomographic features of serous retinal detachment in Vogt-Koyanagi-Harada syndrome. Ophthalmic Surg Lasers Imaging 35:239–242
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Fardeau, C., Tran, T.H.C., Gharbi, B. et al. Retinal fluorescein and indocyanine green angiography and optical coherence tomography in successive stages of Vogt-Koyanagi-Harada disease. Int Ophthalmol 27, 163–172 (2007). https://doi.org/10.1007/s10792-006-9024-7
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DOI: https://doi.org/10.1007/s10792-006-9024-7